NS improves care by deploying Command Centres

The Nova Scotia Health Authority is implementing GE Healthcare’s Command Centre Software Platform at the Queen Elizabeth II Health Sciences Centre (QEII) and hospitals across the province. The technology will provide healthcare administrators and clinicians with a real-time view of capacity utilization, problem spots, and opportunities for process improvements.

The NSHA is the second healthcare organization in Canada to deploy the GE solution and the first to do so province wide. Humber River Hospital in Toronto was an early adopter, acquiring the software in 2017. Providence Health Care in Vancouver is now beginning its implementation for St. Paul’s Hospital, Mount Saint Joseph Hospital and Holy Family Hospital.

Work on the phased deployment in Nova Scotia started in January 2022 and by June, the system was live with the first of six “tiles”, the Capacity Expediter, at QEII.

Capacity Expediter is a web-based app that provides automated, real-time visibility to the current and near-term status of beds. It considers not only patients in beds, but also patients assigned a bed and waiting for them, patients unassigned but needing a bed, outbound transfers, confirmed discharges, and beds blocked for maintenance, staffing, infection control or other reasons.

“We now have an up-to-date, 10,000-foot view of true bed capacity across the QEII Halifax Infirmary and Victoria General campuses and the ability to drill down into specific facilities, programs or individual patient care unit, with just three mouse clicks, saving staff several hours per day manually gathering this information and preparing reports,” said Gord Peckham, who served as Senior Director, C3 Operations during the initial year of the program.

With the foundation in place, three more CCSP components were deployed for QEII: Patient Manager, Boarders Expediter and Inbound Transfers.

These Apps help inpatient unit teams, allied health, medical imaging and C3 expediter staff stay in sync by providing awareness about which patients are where, key dates such as expected discharge date and scheduled procedure date that require action to ensure patient readiness, which patient care tasks have been completed and which need attention, and which patients are at elevated risk requiring intervention due to capacity pressures.

In addition to rolling out Patient Manager to additional hospitals in each zone, ED Expediter and Surgical Growth tiles will be implemented at the QEII in the coming months to support access and flow for emergency and surgical patients, and flagging patients at risk for long waits, delays in care, cancelled procedures and excess days.

Future tiles will accelerate the patient transfer process and provide a real-time, 15-day forward-looking view of OR capacity utilization, flagging patients at risk of cancellation, delay or excess inpatient days.

“Previously, patient flow managers put together manual reports for leadership teams across the site so decisions could be made, and actions taken around access and bed allocation,” said Peckham. “However, these reports would take hours to produce and by the time they were released, some of the data was no longer accurate.” The real-time data extracted from QEII’s STAR software and other systems eliminates this problem.

As an example, Peckham cites the hypothetical case of a delayed CT scan that’s holding up a patient’s discharge.

“Before, staff at the unit level may have tried to expedite the scan on their own. Now, there’s a daily huddle at 10 am in the C3 where these delays are highlighted and escalated with staff from diagnostic imaging in attendance.”

Over 300 hospitals use GE HealthCare’s Command Center software, including 22 health systems in the US, Canada, UK and the Netherlands. Whereas the scope and intent of each program might vary slightly, they all have in common the outcomes of reducing caregiver’s stress (keeping care team members in sync with the latest information about each patient, resolving discharge and other barriers, spotting clinical risks before they escalate, etc.)

The platform also saves caregivers’ precious time by reducing the time spent searching for information, creating reports, making phone calls, and huddling to report out on completed activities.

Patients are benefitting as a direct result. “Boarders Expeditor has helped us reduce risk for admitted patients waiting in the Emergency Department and is helping uncover barriers to transition. Similarly, Patient Manager has shown us ways we can strengthen discharge planning, optimize multidisciplinary rounds, and expedite transfers to social care,” said Jonathan Veale, Interim Senior Director, C3 Operations.

Zahava Uddin, managing director, GE HealthCare Command Centers, describes the architectural differences as well as the interconnectedness between EMRs and Command Center software.

“If you consider EMR systems and other workflow systems as Level One applications in which new patient information is either keystroked in by front line staff or generated by the system itself, then GE HealthCare CCSP is a Level Two application that uses data in Level One systems to bring into focus things that need attention now.

“CCSP was built to constantly ingest real-time streaming messages from various systems, process, parse and persist those messages in sub-seconds, organize them into a data model, constantly re-compute algorithms running against that data model, and serve nurses, allied health staff, physicians, flow managers and others,” she said.

Today, CCSP is ingesting data from Nova Scotia Health’s information systems, including STAR, Meditech, Cerner Millennium, Allscripts Surgical Manager, PHS and others.

In addition to saving caregivers’ time and improving patient care, the technology is helping Nova Scotia Health teams connect and communicate better by providing actionable insights that transcend any one role.

It is also reducing the cognitive burden on staff who work hard at searching for basic information, keeping track of sticky notes, or connecting the dots themselves.